Curriculum setting and students' feedback of pre-clinical training in different dental schools in China-A national-wide survey.

INTRODUCTION: Adequate time and effective training facilities are essential for undergraduate dental students participating in pre-clinical dental practice to ensure them providing safe treatment for patients in the future. The study aimed to explore the current status of pre-clinical dental training in China in relation to the curriculum setting and students' feedback of pre-clinical training in different dental schools and thus provide information for further standardise curricula. MATERIALS AND METHOD: An online questionnaire was distributed electronically to undergraduates in 44 Chinese dental schools of different levels according to China Discipline Ranking (CDR). The questionnaire collected information in relation to the training hour and student to facility ratio of four main dental courses (cariology and endodontics, periodontology, prosthodontics and oral surgery), as well as the application and effect of virtual reality (VR) simulator in pre-clinical dental practice in different schools. Students' feedback was also collected. RESULTS: A total of 565 valid questionnaires were recruited. Results of this cross-sectional survey show that training hour of periodontology course was the lowest, and oral surgery course showed most prominent shortage of facilities. The application of VR simulator amongst schools is uneven. Students from A and A+ level schools showed higher satisfaction with their pre-clinical courses and reported a more positive attitude towards the use of VR simulator than other students. (p < .05). CONCLUSION: Pre-clinical dental training in China remained imperfect in insufficient training time, training facility and students did not have access to standard pre-clinical training and quality assurance. VR technique has potential values in pre-clinical dental practice in China.

Comparison of pain perception, anxiety, and impacts on oral health-related quality of life between patients receiving clear aligners and fixed appliances during the initial stage of orthodontic treatment.

BACKGROUND AND OBJECTIVES: Clear aligner is an advanced orthodontic method with benefits of comfort, aesthetics, and convenience. This study aimed to compare pain perception, anxiety, and impacts on oral health-related quality of life (OHRQoL) between adult patients receiving clear aligners and fixed appliances during the initial stage of orthodontic treatments. MATERIAL AND METHODS: The two groups were well matched by ages, gender, and levels of malocclusion severity. Pain perception, anxiety, and OHRQoL were assessed through visual analogue scale, state-trait anxiety inventory, and oral health impact profile-14 (OHIP-14), respectively. And the comparison of above scores was performed by two-way analysis of variance. RESULTS: A total of 110 patients (55 pairs) were enrolled in this study. Orthodontic pain levels peaked on the first day and decreased gradually afterwards in both groups, which were significantly higher in the fixed group on the first, second, fourth, and fifth days. Likewise, anxiety levels peaked on the first day and decreased thereafter, with significant difference on the 1st, 3d, 5th, 7th, and 14th days. Moreover, the OHIP-14 scores increased and peaked on the first day and then gradually decreased for both groups, which were also significantly higher in the fixed group on the 1st, 7th, and 14th days. LIMITATIONS: More malocclusion types should be used for group matching. The effect of exclusion of small groups should be taken into consideration in sample size calculation. Income was significantly unbalanced between two groups due to higher cost of clear aligners, and random assignment of treatment modalities was unfeasible. CONCLUSIONS: Patients treated with clear aligners experienced lower pain levels, less anxiety, and higher OHRQoL as compared to those receiving fixed appliances.

Integrated Multiplex Sensing Clear Aligner for In Situ Monitoring of Dental Enamel Demineralization.

Clear aligners have become one of the most important tools in orthodontic treatment. However, over a lengthy period of orthodontic treatment, enamel demineralization or even dental caries could be susceptible for occurrence. Therefore, early diagnosis of enamel demineralization has been widely investigated. Nevertheless, for reasons including bulky monitoring equipment and complexity of operation, few techniques reported to date possessed clinical utility. The combination of flexible electronics and electrochemical sensing technology presented a promising strategy. Herein, an integrated multiplex sensing clear aligner (IMSCA) system, including a clear aligner with a multiplex sensor array patch, was developed for in situ monitoring of Ca2+, pH, and PO43- in the oral environment to provide a foundation for early diagnosis of enamel demineralization. The IMSCA exhibited a broad linear response range, great selectivity, temporal stability, reproducibility, and biological safety. Results of enamel demineralization simulating experiments and human permanent tooth demineralization experiments validate the capability of the IMSCA to indicate the occurrence of enamel demineralization. All results ultimately point to the promising clinical utility of the IMSCA, which facilitates the quantitative characterization of enamel demineralization in complex oral environments. This study provides a novel strategy in the early diagnosis of enamel demineralization.

Association of Body Mass Index (BMI) with Lip Morphology Characteristics: A Cross-Sectional Study Based on Chinese Population.

BACKGROUND: Lip morphology is essential in diagnosis and treatment of orthodontics and orthognathic surgery to ensure facial aesthetics. Body mass index (BMI) has proved to have influence on facial soft tissue thickness, but its relationship with lip morphology is unclear. This study aimed to evaluate the association between BMI and lip morphology characteristics (LMCs) and thus provide information for personalized treatment. METHODS: A cross-sectional study consisted of 1185 patients from 1 January 2010 to 31 December 2020 was conducted. Confounders of demography, dental features, skeletal parameters and LMCs were adjusted by multivariable linear regression to identify the association between BMI and LMCs. Group differences were evaluated with two-samples t-test and one-way ANOVA test. Mediation analysis was used for indirect effects assessment. RESULTS: After adjusting for confounders, BMI is independently associated with upper lip length (0.039, [0.002-0.075]), soft pogonion thickness (0.120, [0.073-0.168]), inferior sulcus depth (0.040, [0.018-0.063]), lower lip length (0.208, [0.139-0.276]), and curve fitting revealed non-linearity to BMI in obese patients. Mediation analysis found BMI was associated with superior sulcus depth and basic upper lip thickness through upper lip length. CONCLUSIONS: BMI is positively associated with LMCs, except for nasolabial angle as negatively, while obese patients reverse or weaken these associations.

Association of Upper Lip Morphology Characteristics with Sagittal and Vertical Skeletal Patterns: A Cross Sectional Study.

BACKGROUND: Upper lip morphology is essential in diagnosis and treatment of orthodontics and orthognathic surgery. This study is aimed to evaluate the association between upper lip characteristics (ULCs) and skeletal patterns (SPs). METHODS: 2079 patients were involved and grouped by sagittal and vertical. Class I, II, and III were identified by ANB angle, while normodivergent, hyperdivergent, and hypodivergent were identified by Facial Height Index and Sum of Angles. ULCs were evaluated by superior sulcus depth, nasolabial angle, upper lip length, basic upper lip thickness, and upper lip thickness. Confounders including demography, malocclusion, upper incisors, and upper lips were adjusted by multivariate linear regression to identify the association between ULCs and SPs. Group differences were evaluated with analysis of variance and Chi-square test. RESULTS: The mean value of ULCs and prevalence of SPs were explored in the Western China population. ULCs were significantly different in various sagittal, vertical, and combined SPs. Superior sulcus depth was negatively related to Class II, and positively related to Class III and the hypodivergent pattern after adjusted by confounders. CONCLUSIONS: ULCs significantly varied among different SPs, while only superior sulcus depth was independently associated with SPs, indicating superior sulcus depth is the only ULC that might be significantly corrected by intervention of skeletal growth.

Novel Portable Sensing System with Integrated Multifunctionality for Accurate Detection of Salivary Uric Acid.

Uric acid, as the terminal product of purine metabolism in the body, is an important marker of many diseases. Uric acid is abundant in saliva, offering the possibility of its non-invasive detection. However, it is sensitive to interference in saliva by a variety of factors. A reliable method of processing saliva is centrifugation (CF), but the cost and size of equipment limit its use in everyday life. In this study, a novel portable salivary-sensing system (PSSS) with integrated suction filtration (SF) and temperature insulation was proposed to obtain more accurate salivary uric acid levels through a simple procedure. The PSSS includes a saliva container, a high-sensitive uric acid sensor (UAS), an accompanying printed circuit board (PCB), and a mobile application. The responses produced by the UAS presents excellent linearity (4.6 µA/mM with R2 = 0.9964), selectivity, reproducibility, and stability for the detection of low levels of uric acid. The difference in detection values between the UAS and the commercial sensor is only ~4%. The primary feature of the saliva container is the processing of saliva by SF instead of CF. Samples from CF and SF showed no significant differences regarding uric acid levels, and both exhibited approximately 50% deviation from the untreated samples, while the difference in uric acid levels between the samples after SF and after applying both treatments was ~10%. Besides, insulation of the saliva container can partially eliminate sources of error induced by the environment during uric acid level testing. The PSSS provides a novel strategy for the immediate detection of specific markers in saliva. We believe that the PSSS has promising potential for future application in the rapid saliva testing.

Nerve Growth Factor Enhances Tooth Mechanical Hyperalgesia Through C-C Chemokine Ligand 19 in Rats.

The nerve growth factor (NGF) plays an important role in the regulation of neuropathic pain. It has been demonstrated that calcitonin gene-related peptide (CGRP), a well-known contributor to neurogenic inflammation, increases neuroinflammatory pain induced by NGF. The inflammatory mediator that NGF most strongly induces is C-C chemokine ligand 19 (CCL19), which can recruit inflammatory cells by binding to the receptor CCR7 followed by promoting the response of neuroinflammation. However, the regulatory mechanism of NGF and CCL19 in tooth movement orofacial pain and the interaction between both are still unclear. In this study, male Sprague-Dawley rats were used to study the modulation of NGF on orofacial pain through CCL19 and the role of each in tooth movement pain in rats. The expression levels of CCL19 mRNA and protein were determined by real-time PCR and immunofluorescence, respectively. Pain levels were assessed by measuring the rats' bite force, which drops as pain rises. Meanwhile, by verifying the relationship between CGRP and CCL19, it was laterally confirmed that NGF could modulate tooth movement-induced mechanical hyperalgesia through CCL19. The results showed that the expression level of CCL19 rose with the increased NGF, and neurons expressing CGRP can express stronger CCL19. Compared with the baseline level, the bite force for all rats dropped sharply on day 1, reached its lowest level on day 3, and recovered gradually on day 5. All results indicated that NGF played an important role in tooth movement orofacial pain via positively regulating CCL19 expression in the trigeminal ganglia of rats. Additionally, CCL19 increased the sensitivity to experimental tooth movement orofacial pain. NGF can regulate CCL19 expression, although it may regulate other inflammatory pathways as well. This is the first report on the interactions and modulations of tooth movement orofacial pain by NGF through CCL19 in rats.

[Research progress in the relationship between Veillonella and oral diseases].

Veillonella species, known as the early colonizer of oral biofilm, are prevalent in oral microbiota. Seven Veillonella species have been isolated from oral cavity. Their distribution varies not only with different people but also with different sites in the oral cavity. Oral Veillonella are associated with oral diseases. They contribute to the adhesion of Streptococcus mutans and consume the lactate generated by streptococci. Veillonella species play an important role in the occurrence and development of periodontal diseases by providing adhesion sites for Porphyromonas gingivalis and boosting immune responses. The production of lipopolysaccharide and H2S is related to other oral diseases, such as pulpitis, periapical periodontitis, and halitosis. Several studies have been conducted on the relationship between Veillonella and oral diseases and the interaction between Veillonella and other pathological microorganisms, but limited knowledge is available at the molecular level. This article reviews the research progress in the relationship between Veillonella and oral infectious diseases, such as dental caries and periodontal diseases.

Baicalin loaded in folate-PEG modified liposomes for enhanced stability and tumor targeting.

Bioavailability of baicalin (BAI), an example of traditional Chinese medicine, has been modified by loading into liposome. Several liposome systems of different composition i.e., lipid/cholesterol (L), long-circulating stealth liposome (L-PEG) and folate receptor (FR)-targeted liposome (L-FA) have been used as the drug carrier for BAI. The obtained liposomes were around 80 nm in diameter with proper zeta potentials about -25 mV and sufficient physical stability in 3 months. The entrapment efficiency and loading efficiency of BAI in the liposomes were 41.0-46.4% and 8.8-10.0%, respectively. The morphology details of BAI lipsosome systems i.e., formation of small unilamellar vesicles, have been determined by cryogenic transmission electron microscopy (cryo-TEM) and small angle X-ray scattering (SAXS). In vitro cytotoxicity of BAI liposomes against HeLa cells was evaluated by MTT assay. BAI loaded FR-targeted liposomes showed higher cytotoxicity and cellular uptake compared with non-targeted liposomes. The results suggested that L-FA-BAI could enhance anti-tumor efficiency and should be an effective FR-targeted carrier system for BAI delivery.